• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.42-48
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• 2000

We retrospectively reviewed the results of arthroscopic adhesiolysis on postoperative knee stiffness in order to observe the clinical improvement and to evaluate the prognostic factors. Arthroscopic adhesiolysis without extraarticular procedure was performed in 31 knees displaying persistent flexion or extension loss. The causes of arthrofobrosis were previous ligament surgeries in 17 knees, surgery for a fracture involving the articular surface of the knee in 10 cases and other causes in four cases. The average range of motion was $60^{\circ}(range,\;14^{\circ}-74^{\circ})$ preoperatively, and improved by $120^{\circ}(range,\;7^{\circ}-127^{\circ})$ immediately following the procedure. The range of motion at the final follow-up (average 34 months) was $129^{\circ}(range,\;3^{\circ}-132^{\circ})$. In the 17 patients with arthrofibrosis fellowing ligament surgery, the range of motion was improved from $65^{\circ}$ preoperatively to $135^{\circ}$ at final follow-up. The improvement in function and motion was achieved during the first postoperative year. In the 10 patients with arthrofibosis following intraarticular fractures, the range of motion was improved from $60^{\circ}$ preoperatively to $125^{\circ}$ at the final follow-up, and most of the increase in motion was achieved within the first 6 months. Patients who suffered from a limitation of motion for less than 7 months gained an average $70^{\circ}$ improvement in total range of motion following arthroscopic surgery. However, the total range of motion in patients with a duration of symptoms greater than 7 months improved by an average $49^{\circ}$ postoperatively. In conclusion, arthroscopic adhesiolysis without incisional procedure is an effective therapeutic modality in arthrofibrosis of intraarticular origin. Improved outcomes can be expected in stiffness after ligament surgery and a symptom duration of arthrofibrosis less than 7 months.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.53-57
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• 2008

Purpose: We analyzed the clinical results after arthroscopic treatment in acute pyogenic arthritis of the knee. Materials and Methods: From July 2000 to January 2005, we reviewed 16 cases(15 patients) of acute pyogenic arthritis of the knee on which arthroscopic treatment was done. The mean age was 61.9 years and the mean follow-up period was 30.5 months. There were 8 cases with diabetes or degenerative osteoarthritis and 14 cases with acupuncture or intraarticular injection history. Results: Causative organisms were identified in 7 cases. The average postoperative antibiotics were used intravenously for 25.5 days and per orally for 22.5 days. There were 11 complications; 5 cases of partial ankylosis, 2 cases of secondary arthritis, 1 case of chronic osteomyelitis and 3 cases of death. Patients with over 3 week immobilization had higher rate of stiffness of knee joint(p=0.032) but there was no significant difference between the symptom to treatment duration and the incidence rate of complications(p=0.293). The cases of which the causative organism was detected had higher incidences of complications(p=0.034). Conclusion: The incidence of joint stiffness was higher in the patients of longer immobilization. More complications were detected in the cases of which the causative organism is detected.

• Journal of the Korean Orthopaedic Association
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• v.56 no.3
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• pp.253-260
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• 2021

Purpose: The least constrained prosthesis is generally recommended in primary total knee arthroplasty (TKA). Nevertheless, a varus/valgus constrained (VVC) prosthesis should be implanted when a semi-constrained prosthesis is not good for adequate stability, especially in the coronal plane. In domestic situations, however, the VVC prosthesis could not always be prepared for every primary TKA case. Therefore, it is sometimes impractical to use a VVC prosthesis for unsual unstable situations. This study provides information for preparing VVC prostheses in the preoperative planning of primary TKA through an analysis of primary VVC TKA cases. Materials and Methods: This study reviewed 1,797 primary TKAs, performed between May 2003 and February 2016. The reasons for requiring VVC prosthesis and the preoperative conditions in 29 TKAs that underwent primary TKA with a VVC prosthesis were analyzed retrospectively. Results: In primary TKA, 29 cases (1.6%) in 27 patients (6 male and 21 female) used VVC prosthesis. Two patients underwent a VVC prosthesis on both knees. The mean age of the patients was 63.4 years old (34-79 years). The mean flexion contracture was 16.2° (-20°-90°), and the mean angle of great flexion was 111.7° (35°-145°). The situations requiring a VVC prosthesis were severe valgus deformity in 10 knees, knee stiffness requiring extensive soft tissue release in 10 knees, previously injured collateral ligaments in five knees, and distal femoral bone defect due to avascular necrosis in four knees. The mean tibiofemoral angle was 25.7° (21°-43°) in 10 cases with a valgus deformity. The mean flexion contracture was 37.5° (20°-90°), and the mean range of motion was 48.5° (10°-70°) in 10 cases with knee stiffness. Conclusion: The preparation of VVC prosthesis is recommended, even for primary TKA in cases of severe valgus deformity (tibiofemoral angle>20°), stiff knee (the range of motion: less than 70° with more than 20° flexion contracture), and the cases with a previous collateral ligament injury. This information will help in the preparation of adequate TKA prostheses for unusual unstable situations.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.39-45
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• 2009

Purpose: To investigate the outcome of arthroscopic treatment for the complications of knee arthroplasty and to evaluate the effectiveness of arthroscopy. Materials and Methods: We analyzed 25 patients who underwent arthroscopy to treat complications of knee arthroplasty between May 1992 and June 2008. Nineteen cases out of 25 had total knee arthroplasty (TKA) and the remaining 6 cases had unicompartmental knee arthroplasty (UKA). Before arthroscopy, physical examinations and radiographic evaluations were carried out to find out the causes of complications. Joint fluid aspiration and hematologic evaluation were added when infection was suspected. Results: Among the diagnosis at the time of arthroscopy, there were 11 cases of infection, 6 cases of stiffness due to adhesion and fibrosis, and 2 cases of soft tissue impingement in the cases of TKA. Among the cases of UKA, one for each case of meniscal tear, subluxation of mobile insert, hemarthrosis, cement loose body, soft tissue impingement, and stiff knee was found. Nine out of 11 patients who had infection were treated successfully with arthroscopy but the remaining 2 cases underwent revision arthroplasty. Seven patients with arthrofibrosis had improved range of motion from $65^{\circ}$ preoperatively to $105^{\circ}$ postoperatively. The others also showed successful results after arthroscopy. Conclusion: Arthroscopy to treat complications after knee arthroplasty was a safe and effective method when appropriate selection of patients was made.

• The Journal of Korea CHUNA Manual Medicine
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• v.5 no.1
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• pp.141-150
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• 2004

Objectives : The objective of this study is to evaluate the treatment effect of Oriental therapy including exercise therapy in chronic ankylosing spondylitis with total hip replacement. Methods : Oriental therapy and exercise therapy were performed for 64days admission in a patient who had chronic ankylosing spondylitis with total hip replacement and physical tests were examined. Result : Pain and ROM of cervical. lumbar spine, and left hip joint has improved with this treatment. And Anorexia, dyspepsia, and fatigue were also decreased. Conclusions: In this case, oriental therapy was proved to be effective in improving chronic symptoms and general prostration of Ankylosing Spondylitis. And It is necessary to carry out exercise therapy regulary.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.211-216
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• 2008

Purpose: The frequency of foreign body in the knee joint is not as high, but it sometimes required wide or multiple arthrotomy in order to remove, which can baffle the surgeon in some ways. Our study is to evaluate for effectiveness of arthroscopic retrieval for intra-articular foreign body in the knee joint. Materials and Methods: The 22 patients(16 males, 6 females) had received arthroscopic foreign body retrieval in the knee joint from March 1983 to September 2006. The causes of foreign bodies of the knee joint were 7 of trauma (31.9%) related cases, 13 of surgery related cases (59.0%), 2 found during follow up after operation (8.1%) in pathologies of foreign body. Results: There were 15 of metal showed the most percentage (68.1%), 7 of non-metal (31.9%) in types of foreign bodies, and others included bullet, suture material, pencil lead, broken wire etc. All cases were used by arthroscopic techniques. All foreign bodies were removed easily and were showed no complication such as postoperative joint stiffness. Conclusion: Arthroscopic foreign body retrieval in the knee joint is effective surgery in terms of easy access to foreign body and less postoperative complication.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.1
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• pp.66-68
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• 2012

Lumbar disc herniation in the adolescent is rare. The clinical features of adolescent lumbar disc herniation are typically different from those of adults. Many adolescent with that disease may be misdiagnosed as minor trauma, muscle sprain, tight hamstrings or scoliosis. Published series reiterate that adolescents, as opposed to adults, do not respond well to conservative treatment. In adolescent lumbar disc herniation with hamstring tightness, the neurologic defects are improved shortly after, discectomy, but the hamstring tightness continue and remain even after 1 year. Earlier discectomy and adjunct postsurgical conservative measures can provide a greater opportunity for correction and stabilization of scoliotic posture. We here report on a case of adolescent lumbar disc herniation that was misdiagnosed by knee injury during 2 years. After posterior partial discectomy, the hamstring tightness and scoliosis was disappeared without complication.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.103-107
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• 2006

Simultaneous acute rupture of the anterior cruciate ligament (ACL) and the patellar tendon is a very unusual injury. That is difficult to diagnose in initial evaluation of knee injury, because the patellar tendon rupture is often missed. We report a 26 year-old male patient who was treated with ACL reconstruction using achilles allograft and direct patellar tendon repair with achilles allograft augmentation. The patient had the stable knee and full range of motion. It's clinical results were excellent(Lysholm score 93, Tegner activity score 6).

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.498-504
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• 2018

Purpose: To evaluate the clinical and radiological outcomes, and the complications of unicompartmental knee arthroplasty (UKA) using a fixed bearing prosthesis after 5-year follow-up. Materials and Methods: Twenty-six knees (25 patients) that underwent fixed bearing UKA between May 2003 and August 2011 were included. The subjects were 3 males (3 knees) and 22 females (23 knees), and the average age was 63.5 years. The preoperative diagnosis was osteoarthritis (23 knees) and osteonecrosis (3 knees). The mean follow-up duration was 67 months (from 60 to 149 months). The clinical evaluation included pre- and postoperative American knee society knee and function score, and range of motion. The radiology evaluation included standing antero-posterior, lateral view, and fluoroscopic film to analyze the postoperative alignment and osteolysis. Results: The mean American Knee Society knee score and function score were improved from 42.0 and 57.5 to 87.9 and 85.0, respectively (p<0.001). The mean preoperative and postoperative range of motion was $132.9^{\circ}$ and $132.5^{\circ}$, respectively. The mean femorotibial angle were varus $0.5^{\circ}$ preoperatively and valgus $2.2^{\circ}$ postoperatively. A radiolucent line was observed in 2 knees; one knee had a stable implant, while in the other knee, patellofemoral arthritis was identified during UKA. Diffuse pain of the knee joint with tenderness of the medial joint line was identified at the follow-up, so conversion to total knee arthroplasty was recommended. No other complications, such as osteolysis, infections, postoperative stiffness, and dislocation, were encountered. Conclusion: The midterm results of fixed bearing UKA were clinically and radiologically satisfactory.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.246-250
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• 2007

Total elbow arthroplasty is a relatively rare procedure compared with total knee or total hip arthroplasty. Total elbow arthroplasty for bony ankylosis is even rarer, and the results are often unsatisfactory. We report a patient who gained good mobility of the elbow after total elbow arthroplasty for the treatment of fractured arthrodesis site with which the patient had lived with for 12 years.